The same symptoms have different meanings in different contexts, and in relation to other symptoms–and it can make a huge difference. The anxiety of an otherwise high-functioning person virtually paralyzed at a microphone is a whole different issue than the agitation of a person with paranoid delusions. One may get a beta blocker and cognitive-behavioral therapy, the other an antipsychotic and supportive services.
Diagnosis is complicated.
Psychologists and other qualified professionals take a history, do a psychosocial interview, observe things like mood, facial expressions, body language, speech (rate, rhythm, pitch), even grooming (hygiene, dress, makeup, hair can tell you a lot), use screening tools that may take five minutes or do a complete psychological assessment battery that can take all day–and about four more to score, interpret, and write up. And then they consult an 837-page manual (American Psychiatric Association, 2013).
All this to get a diagnosis and a treatment plan. Before managed care, I would never commit to a diagnosis before the third session. You can Google yourself and get it right the first time, or be tragically wrong. As a clerk in a health food store, you can toss off a diagnosis and change the course of someone’s life for the better… or not.
Training matters.
A clinical psychologist in their first week of independent practice already boasts up to 6,000 clock hours (yeah, you read that right: six thousand hours, by the clock) of supervised practice, on top of 7 years or more (I had about 8½) of classwork. And they will have written, and sometimes published, a thesis or dissertation in their area of expertise. After all of which they’ve passed a four-hour licensing exam if they’re in the States.
Again, you can take your chances with Claude and Dr. Google, and you may be OK. But what if you aren’t?
Now I’ll be the first to admit you can also spend hundreds of dollars to get a wrong diagnosis and bad advice. We’ve all seen it happen. I’ve cleaned up after some of those messes, and I’ve made a couple myself in 30 years of practice.
So when might you head for the internet or the nearest vitamin store?
It’s a crapshoot. I get that. But if you’re having serious problems, I think your odds are better with a pro. So I’d suggest you ask yourself, “What are the possible consequences if I’m wrong?” and act accordingly. If you could end up in jail, divorced, or dead, seek professional advice. If the worst that can happen is that you waste a few bucks on a worthless vitamin supplement, go for it. Why not?
I think the other time to ‘do your own research’ is when you have the nagging suspicion that your doc is wrong. I’m sure we’ve all known or heard of situations in which people caught something in the nick of time that way, and thank heaven they did.
Have you ever self-diagnosed after watching TikTok videos, Googling your symptoms, or asking an LLM like ChatGPT for advice? How did that work out? Did you save yourself some suffering (and maybe a boatload of money)? Did you identify something big that your doc missed? Dodge a treatment plan that could have been destructive? Or did you find out later that you were off by a mile?
I’m doing a little of this myself right now, with a weird diagnosis that popped up in MyChart this summer that I think is dead wrong: I’ll let you know how it turns out!
Coming up: A longer piece on just how wrong some self-proclaimed experts can be, and how to tell. Enter your email below to receive notifications:
And as always, if this was helpful in any way, please… buy me a coffee!
References
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed). American Psychiatric Association.
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